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Aug 19, 2013 at 12:01 AMAug 19, 2013 at 2:38 PM

Gov. Pat McCrory’s new Medicaid chief came into her job with her work cut out. She arrived to a brutal state performance audit that found, among other things, a lack of oversight coupled with considerable overspending on services – much of it due to the aforementioned poor oversight. She and the governor should address those concerns before attempting to undo part of the program that has been working, at least according to doctors and medical-care advocates.

Gov. Pat McCrory’s new Medicaid chief came into her job with her work cut out. She arrived to a brutal state performance audit that found, among other things, a lack of oversight coupled with considerable overspending on services – much of it due to the aforementioned poor oversight. She and the governor should address those concerns before attempting to undo part of the program that has been working, at least according to doctors and medical-care advocates.

While there is no question that better tracking of Medicaid expenses and a much-improved administrative oversight system are necessary, the Community Care program is one aspect that has received considerable national attention – because it is helping to ensure better coordination of care for Medicaid recipients.

The state audit released in January focused mainly on administrative deficiencies and overspending due to a lack of oversight. State Auditor Beth Wood did not address the care delivery system.

It has been abundantly clear for quite some time that administrators did not have a good handle on spending, especially when it comes to ensuring that private providers were not overbilling. Over the past few years there have been several cases in which private providers were billing for services based on a higher level of care rather than what was actually provided, or were paid more than the budget allotted because there was no effective way to track Medicaid spending handled by other departments.

As a result of this and other blunders, the Medicaid program was in trouble with federal regulators and had little control of spending.

Rising Medicaid costs overall added to the state’s budget constraints and led to cost controls that angered recipients of those services and their families.

Medicaid Director Carol Steckel, who came with a good track record, was hired to fix what’s broken and to consolidate the administration of Medicaid spending. But there is a difference between cleaning house and throwing out a care coordination program that has received national acclaim.

Doctors and patient advocates say the Community Care program is working. Patients have a “medical home” so that one agency is monitoring the services that patient receives.

Without question there needs to be better monitoring of how money is spent to rein in overpayments, but the service delivery system seems to be more in need of some smart modifications than privatization.

Opponents worry that private contractors will be more focused on profits than on patient care and that overhauling the entire patient care system will result in additional work and more red tape for them. Advocates also worry that patients will be denied the care that they need, and cite serious problems incurred by other states after they implemented a managed-care system. At least one state has even considered tossing out its managed-care system in favor of a model like North Carolina’s.

Just because a program is new does not make it better. Just ask anyone who is familiar with the mental health “reform” ushered in under former Gov. Mike Easley. In that case, moving care from public agencies to private contractors was a big part of the problem.

Medicaid accounts for about a fifth of the state budget, and the state owes it to the taxpayers to control costs and make sure that money is well spent. But let’s make sure we’re not throwing out an imperfect system and replacing it with something even worse.

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